Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis

Giovanni Mauri, Luca Maria Sconfienza, Lorenzo Carlo Pescatori, Maria Paola Fedeli, Marco Alì, Giovanni Di Leo, Francesco Sardanelli

Research output: Contribution to journalReview article

Abstract

OBJECTIVES: To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments.

METHODS: An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome.

RESULTS: Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142).

CONCLUSIONS: Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low.

KEY POINTS: • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

Original languageEnglish
Pages (from-to)3199-3210
Number of pages12
JournalEuropean Radiology
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Ablation Techniques/adverse effects
  • Breast Neoplasms/surgery
  • Cryosurgery
  • High-Intensity Focused Ultrasound Ablation
  • Humans
  • Microwaves/adverse effects
  • Minimally Invasive Surgical Procedures/adverse effects
  • Postoperative Complications

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